Abstract The IDeA State Pediatric Clinical Trials Network (ISPCTN) will provide access for underserved and rural populations to state-of-the-art clinical trials creating a unique opportunity to expand pediatric research across South Carolina (SC). The Trials and ReseArch NetworkS FOR More- South Carolina (TRANSFORM SC) project will connect pediatric investigators with experience in multi-center clinical trials with pediatric providers interested in developing experience in pediatric research and expanding access to trials and research for their patients. This project will establish pediatric clinical trials teams at the TRANSFORM SC sites, enabling pediatric clinical trials throughout the state of SC. Teams will receive professional development and support to establish needed infrastructure to participate in future ISPCTN clinical trials. The TRANSFORM SC leadership team will provide oversight, mentoring and additional clinical trial support for the developing research teams, through a combination of in person training and a central Virtual Clinical Trials Office utilizing resources available through the South Carolina Translational Research Institute, Health Sciences South Carolina and the SC Telehealth Research and Innovation Program. TRANSFORM SC will integrate with the Data Coordinating and Operations Center to maximize training and research capability at SC sites through learning state-of-the-art techniques in clinical trials for rural and underserved populations across SC. An Access, Collaboration, and Engagement (ACE) Core will be established to work with sites to provide means for both internal and external access, collaboration and engagement. Sites will establish registries of families interested in being contacted for research, in order to both consolidate their training, as well as to prepare and accelerate recruitment into ISPCTN and Environmental Influences on Child Health Outcomes (ECHO) program studies. This core will also provide access for researchers developing protocols, to better understand the needs of children in rural and underserved location.